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The Obama administration announced a special enrollment period from March 15 to April 30 for healthcare.gov consumers who discover they owe a penalty after filling out their tax returns. (Phil Galewitz,
2/20)

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Summaries Of The News:

The Friday announcement follows requests from advocacy groups who said many people will not realize the consequences of being uninsured in 2014 until they file their taxes -- and by then they can't sign up for 2015 coverage. A new study from the Urban Institute seeks to quantify the problem.

The Wall Street Journal:
Obama Administration Extends Health Law Sign-Up Through Tax-Filing Season
The Obama administration said it would allow people to sign up for plans on HealthCare.gov through April to avoid tax penalties for going uncovered in 2015. The extension, which adds more than two months to the enrollment period for health coverage this year, was announced by Health and Human Services officials on Friday. People who pay penalties for going uncovered in 2014 and are still uninsured will be allowed to visit HealthCare.gov until the end of April, said Andy Slavitt, principal deputy administrator at the Centers for Medicare and Medicaid Services, the HHS unit overseeing implementation of the law. (Radnofsky, 2/20)

Kaiser Health News:
Tax Time Reprieve For Obamacare Procrastinators
The Obama administration said Friday it will allow a special health law enrollment period from March 15 to April 30 for consumers who realize while filling out their taxes that they owe a fee for not signing up for coverage last year. The special enrollment period applies to people in the 37 states covered by the federal marketplace, though some state-run exchanges are also expected to follow suit. (Galewitz, 2/20)

The Hill:
Obamacare Penalties Could Come As a Shock
Almost half of uninsured adults are unaware that there is a financial penalty for lacking health insurance, according to a study released Thursday by the Urban Institute. The study, using data from December, found that roughly 25 percent of uninsured people above the poverty line had heard "nothing at all" about the penalty, and around 20 percent had heard "only a little." Fifty-three percent had heard some or a lot. (Sullivan, 2/19)

Kaiser Health News:
Many Uninsured Don’t Realize They May Face A Tax Penalty
A “teachable moment” is one way to describe the consternation that many uninsured people may feel when they file their taxes this spring and realize they owe a penalty for not having health insurance. According to a new survey, the number of people who may need to be schooled is substantial: Forty-four percent of uninsured people who may be subject to the penalty say they know nothing or only a little about the penalty they may face. (Andrews, 2/20)

Reuters examines the legal strategy behind the case, while USA Today looks at the obstacles it faces. Other outlets report on aspects of the law's implementation including the 2015 enrollment effort, congressional opposition and the argument that the law is driving employers to move more workers to part-time positions.

Reuters:
For Obamacare Challengers, A Supreme Court Case Built For Speed
The U.S. Supreme Court case that could shatter President Barack Obama's healthcare law this year was launched as a backup plan by a libertarian group and a powerful Washington lawyer frustrated by the slow progress of their original lawsuit. Their success in persuading the court to take the ideologically driven case owes to a combination of canny legal tactics and the willingness of at least four justices to hear it in unusually swift time. Oral arguments are set for March 4. (Biskupic, 2/20)

USA Today:
Supreme Court Case Against Obamacare Faces Obstacles
A legal challenge that threatens to unravel President Obama's health care law has been stricken by a series of ill-timed setbacks before next month's Supreme Court showdown. The four plaintiffs' qualifications to bring the lawsuit have been cast in doubt because of their low incomes and potential eligibility for other government benefits. At least one of the four Virginians must show that the law constitutes a burden. (Wolf, 2/19)

PBS NewsHour:
A Look At The Challenges Threatening The Health Of Obamacare
More than 11 million people have signed up for insurance coverage in the second year of the new marketplaces. That’s higher than year one, when 6.7 million people ultimately enrolled through federal or state exchanges. But there are big questions ahead. ... Sylvia Mathews Burwell is the secretary of health and human services. I sat down with her earlier today at the agency’s headquarters. (Ifill, 2/19)

Fact Check/USA Today:
Moving The Goalposts On ACA Enrollment
President Obama says the Affordable Care Act is working "a little bit better than we anticipated," based on the 11.4 million people who signed up for insurance on the exchanges during the recent open enrollment period. That's better than the administration anticipated, but worse than a Congressional Budget Office projection. (Robertson, 2/19)

The Hill:
Vitter: Clerks Are Blocking ObamaCare Investigation
Sen. David Vitter (R-La.) is claiming that congressional clerks are stonewalling his investigation into why some staffers are allowed exemptions from ObamaCare. Vitter has aggressively opposed a provision of ObamaCare that allows certain congressional aides to receive employer subsidies to buy healthcare insurance, which he calls “Washington’s ObamaCare exemption.” (Ferris, 2/19)

CNN:
Poll: Obama's Approval Ratings Stagnant Despite Economy
Obama fares worse on handling health care policy than he does on the economy. In the new poll, 58% disapprove of his work on health care, while just 41% approve. The negative tilt comes just as his signature domestic policy legislation, the Affordable Care Act, faces a Supreme Court challenge which could eliminate subsidies that some low-income people have used to purchase health insurance. (Agiesta, 2/19)

Many states -- and the federal government -- have extended the deadline for people who were in the process of enrolling but hadn't finished by last Sunday. But in some areas, the extensions are even more generous. In addition, Illinois' marketplace director resigns and Connecticut's acting chief gets the job in his state.

USA Today:
For Some, There's Still Time To Enroll In Obamacare
Miss the Obamacare deadline last Sunday? You may still be able to sign up for health coverage. The federal government and every state running its own health insurance exchange have extended deadlines for some consumers – although the rules differ depending on where you live. Jennifer Sullivan, director of the Best Practices Institute for the non-profit Enroll America, suggests people look into the rules in their own states if they think they might qualify. (Ungar and O'Donnell, 2/19)

The Associated Press:
Executive Director Of Get Covered Illinois Resigns
A key government leader in Illinois' health insurance enrollment efforts over the past two years has resigned. Jennifer Koehler was executive director of Get Covered Illinois and part of former Gov. Pat Quinn's administration. She oversaw federal grant programs promoting insurance coverage, including advertising and in-person outreach. (2/19)

Connecticut Mirror:
Special CT Obamacare Enrollment Period? Stay Tuned
People who didn’t have insurance last year – and didn’t have a valid excuse – will have to pay a fee when they file their taxes. That might prompt them to want to get coverage this year. But for those who haven’t filed their taxes yet, it will be too late, because the sign-up period for individual-market insurance ended Sunday. That’s led some to urge health insurance exchanges to hold special enrollment periods for people who paid fees for not having insurance on their taxes. The head of Connecticut’s exchange, acting Access Health CT CEO Jim Wadleigh, said he’s gotten a number of requests to do so. He said officials will announce a decision at the end of February. (Levin Becker, 2/19)

The Associated Press:
Campaigns, Penalties Drive Health Insurance Signup
More prominent marketing campaigns, fear of potential tax penalties and an overall better understanding of the nation's health care law drove thousands of South Dakota residents to sign up for private health insurance during the second enrollment period that ended Sunday, health insurers said, resulting in a 60 percent increase in signups from last year. A federal report released by the U.S. Department of Health and Human Services this week shows that 21,183 South Dakotans selected a plan during the three-month enrollment season, that's about 8,000 more signups compared to last year. (Cano, 2/19)

The Tennessean:
Agencies Scrap Over Releasing Lawmaker Health Plan Info
Although a handful of lawmakers officially killed Gov. Bill Haslam's controversial health care plan earlier this month, the battles related to Insure Tennessee aren't over. Right now two state agencies are fighting over whether they must release details about the public health insurance benefits that go to most of Tennessee's 132 state lawmakers. (Boucher, 2/19)

Republican Gov. Pat McCrory says he won't make a recommendation on expanding the health program for poorer Americans until the Supreme Court rules on the legality of some subsidies. Elsewhere, Montana considers partial expansion of the program, and Utah's debate continues.

CQ Healthbeat:
Debate Over Expanding Medicaid Heats Up In Utah, Montana
The debate over expanding Medicaid is moving forward in states including Utah and Montana while stalling at least temporarily in North Carolina after the Republican governor there said he wants to wait until a Supreme Court ruling on federally-subsidized private health insurance this summer. Even in states that are not weighing Medicaid expansion, the health care program for the poor is under examination, in large part because it is one of the largest components of state budgets. In Illinois, GOP Gov. Bruce Rauner is proposing cuts of almost $1.5 billion to Medicaid. (Adams, 2/19)

In California, lawmakers decide to revisit a moratorium on some Medi-Cal providers --

The announcement tells doctors and hospitals that because the device is difficult to disinfect, it may spread dangerous infections, such as the bacteria responsible for killing two people at UCLA's hospital.

Los Angeles Times:
FDA Knew Of Design Flaw In Scope Linked To UCLA Superbug
A commonly used medical scope linked to a deadly bacterial outbreak at UCLA may be so flawed it cannot be properly cleaned, federal officials conceded Thursday. But they stopped short of recalling the device or outlining any new sterilization procedures. The U.S. Food and Drug Administration has known about the potential problems for more than two years, and took action only after The Times reported this week that two patients died in a new superbug outbreak at UCLA's Ronald Reagan Medical Center. (Levey, Terhune and Willman, 2/19)

Los Angeles Times:
Patient's Family Cites Earlier Case Of Superbug At UCLA
UCLA hospital officials said they began investigating the possibility of a deadly bacterial outbreak in mid-December, but one patient's account suggests they missed a chance to discover the problem much earlier. That patient, an 18-year-old man still hospitalized at UCLA Ronald Reagan Medical Center, was first diagnosed in October with the drug-resistant superbug CRE after he was treated with a medical scope tied to outbreaks at hospitals across the country, his attorney said Thursday. UCLA declined to discuss specific patients but said it acted swiftly as soon as it discovered the problem. (Terhune, Panzar and Petersen, 2/19)

The Associated Press:
Los Angeles Hospital 'Superbug' Takes Toll On Infected
Among the seven people infected by a "superbug" outbreak tied to medical instruments at a Los Angeles hospital is an 18-year-old student who has spent nearly three months in the hospital and is in grave condition, his attorney said. The young man was struggling not to become the third of those infected at Ronald Reagan UCLA Medical Center to die, Attorney Kevin Boyle said Thursday. (Chang and Rogers, 2/20)

The Wall Street Journal:
FDA Issues Warning On Medical Device After Superbug Outbreak
The Food and Drug Administration issued a warning Thursday for a medical device widely used in hospitals that has been linked to an outbreak of a drug-resistant bacterial disease and may have contributed to the deaths of two patients and the possible infection of as many as 179 others in Los Angeles. ... The patients at UCLA underwent medical procedures between October and January using a type of endoscope that is also known as duodenoscope. It is used to diagnose and treat diseases of the liver, bile ducts and pancreas, according to UCLA. (McKay and Burton, 2/19)

The Washington Post:
FDA Warns About Medical Scopes After ‘Superbug’ Hits California Hospital
The Food and Drug Administration on Thursday warned doctors and hospitals that a commonly used type of medical scope can be difficult to sanitize between uses and “may facilitate the spread of deadly bacteria.” The agency’s warning came a day after news broke that seven patients had been infected by a drug-resistant “superbug” at UCLA’s Ronald Reagan Medical Center since last fall. Two of the patients died, and public health authorities are tracking down nearly 200 others who might have been exposed to the dangerous bacteria through the use of the contaminated medical scopes. (Dennis, 2/19)

The New York Times:
Deadly CRE Germs Linked To Hard-To-Clean Medical Scopes
The CRE germs usually strike people receiving medical care in hospitals or nursing homes, including patients on breathing machines or dependent on catheters. Healthy people are rarely, if ever, affected. But the bugs attack broadly, and the infections they cause are not limited to people with severely compromised immune systems, said Dr. Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention. “This is exactly what we are worried about,” Dr. Frieden said of the California infections in an interview. “CRE is becoming increasingly common in hospitals around the U.S. If we aren’t careful, it may well get out into the community and make common infections, like urinary infections, and cuts potentially deadly.” (Tavernise, 2/19)

USA Today:
Superbug Cases Spur FDA Warning On Dirty Medical Scopes
The Food and Drug Administration warned doctors and hospitals Thursday to use extra caution in disinfecting a hard-to-clean medical scope that has been linked to the spread of powerful "superbugs" in outbreaks across the country. The agency said that even meticulous cleaning of the duodenoscopes, which are used on about 500,000 patients a year, may not entirely eliminate the risk. And it advised doctors and hospitals that it is studying possible solutions, including new disinfection protocols. (Eisler and Stanglin, 2/19)

The Associated Press:
'Superbug' Outbreak Raises Questions About Medical Scope
A "superbug" outbreak suspected in the deaths of two Los Angeles hospital patients is raising disturbing questions about the design of a hard-to-clean medical instrument used on more than half a million people in the U.S. every year. ... The infections may have been transmitted through two contaminated endoscopes that were used to diagnose and treat pancreatic and bile-duct problems. The instruments were found to have "embedded" infections even though they had been cleaned according to manufacturer's instructions, said Dr. Robert Cherry, the hospital's chief medical and quality officer. Five other scopes were cleared. (Chang, 2/20)

Los Angeles Times:
Q&A Superbug: What It Is, How It Spreads, What You Can Do
CRE superbugs are becoming more widespread in hospitals and other healthcare facilities. They can cause infections that are difficult -- or sometimes impossible -- to treat. At least seven patients at UCLA's Ronald Reagan Medical Center have been sickened with CRE infections in recent weeks, and two have died. Here's what you need to know about CRE. (Morin and Brown, 2/19)

NPR:
Why California's Superbug Outbreak Isn't As Scary As It Seems
News reports are describing a "nightmare superbug" killing people in California. But scientists who study infectious diseases say the risk from this outbreak doesn't live up to the alarming headlines. "It's not something that is likely to spread around the community or is a cause for alarm," says David Perlin, an infectious disease scientist and executive director of the Public Health Research Institute at Rutgers. (Hamilton, 2/19)

Kaiser Health News:
UCLA Bacteria Outbreak Highlights The Challenges Of Curbing Infections
The bacterial outbreak at a Los Angeles hospital highlights shortcomings in the federal government’s efforts to avert the most lethal hospital infections, which are becoming increasingly impervious to treatment. Government efforts are hobbled, infection control experts say, by gaps in monitoring the prevalence of these germs both within hospitals and beyond. The continued overuse of antibiotics — due to over-prescription by doctors, patients’ insistence and the widespread use in animals and crops — has helped these bacteria evolve into more dangerous forms and flourish. (Rau, 2/20)

Bloomberg:
Superbug Spread Reveals Thin Pipeline Of Newest Antibiotics
Every year at least 23,000 Americans die from bacterial infections that don’t have effective treatments, including two patients killed in a recent outbreak in a Los Angeles hospital that has spurred new attention on the issue. While public health experts say the risk from infections of drug-resistant “superbugs” has been growing, the pipeline of new antibiotics to treat them hasn’t kept pace. Doctors are forced to rely on decades-old medicines with sometimes heavy side effects to treat everything from urinary tract infections to deadly hospital-acquired bacteria such as carbapenem-resistant Enterobacteriaceae, the pathogen in the Los Angeles cases. (Koons, 2/19)

And The New York Times reports on another problem with drug resistance.

The New York Times:
Malaria In Widening Area Resists Drug, Study Finds
The world’s best drug for treating malaria, a medicine that is the key to saving millions of lives in Africa and beyond, is losing its efficacy in a much larger swath of territory than was previously known, according to research that was released Friday. The study, in The Lancet Infectious Diseases, a medical journal, raises the troubling prospect that resistance to the drug, artemisinin, might one day severely hamper treatment of a disease that kills hundreds of thousands of people every year. (Fuller, 2/19)

A panel of nutrition experts is advising Americans to consider the environment when choosing food. The panel also recommended Americans lower their sugar intake but would ease guidelines restricting cholesterol.

The Wall Street Journal:
Diet Experts Push More Plants, Less Meat In Nod To Environment
U.S. dietary guidelines, the government’s benchmark for balanced nutrition, have long advised Americans to eat dark, leafy greens. Now, there is another way the standards could be going green. A panel of nutrition experts recruited by the Obama administration to help craft the next set of guidelines, to be issued this year, said in long-awaited recommendations Thursday that the government should consider the environment when deciding what people should eat. (Tracy, 2/20)

The Washington Post:
Think Of Earth, Not Just Your Stomach, Panel Advises
The nation’s top nutritional panel is recommending for the first time that Americans consider the impact on the environment when they are choosing what to eat, a move that defied a warning from Congress and, if enacted, could discourage people from eating red meat. Members of Congress had sought in December to keep the group from even discussing the issue, asserting that while advising the government on federal dietary guidelines, the committee should steer clear of extraneous issues and stick to nutritional advice. (Ferdman and Whoriskey, 2/19)

USA Today:
Nutrition Panel Urges Americans To Eat Green
Americans should consider the health of the planet along with the health of their hearts when deciding what to eat, according to an expert panel that advises the federal government on nutrition. It is the first time the advisory committee, which updates its recommendations in a report every five years, has considered the environmental impact of food choices. (Szabo, 2/19)

Los Angeles Times:
Cholesterol Is Back On The Menu In New Federal Dietary Guidelines
Go ahead and make that omelet. A new draft of the federal government’s healthy eating guidelines is poised to scramble some long-standing advice on cholesterol-rich foods. Nutrition and public health experts advising the federal government recommended Thursday that cholesterol no longer be labeled a “nutrient of concern” — a designation that for decades has prompted health-conscious Americans to avoid eggs and other foods that are high in the fat-like substance. (Healy, 2/19)

The New York Times:
Nutrition Panel Calls For Less Sugar And Eases Cholesterol And Fat Restrictions
A nutrition advisory panel that helps shape the country’s official dietary guidelines eased some of its previous restrictions on fat and cholesterol on Wednesday and recommended sharp new limits on the amount of added sugars that Americans should consume. The Dietary Guidelines Advisory Committee, which convenes every five years, said that Americans were eating too much salt, sugar and saturated fat, and not enough foods that fall into a “healthy dietary pattern,” like fruits, vegetables, nuts, whole grains and fish. (O'Connor, 2/19)

NPR:
Nutrition Panel: Egg With Coffee Is A-OK, But Skip The Side Of Bacon
If you like a cup of coffee and an egg in the morning, you've got the green light. A panel of top nutrition experts appointed by the federal government has weighed in with its long-awaited diet advice. Their conclusions are that daily cup of joe (or two) may help protect against Type 2 diabetes and cardiovascular disease. And an egg a day will not raise the risk of heart disease in healthy people. Hold the sugary muffin, though. ... The committee says Americans should shift to a pattern of eating that includes more plant-based foods. And, the panel concludes, Americans should eat less sugar and meat, specifically red meat and processed meat. (Aubrey, 2/19)

The Associated Press:
Healthful Diet Report: Sugary Drinks Out; Coffee, Eggs In
An extra cup or two of coffee may be OK after all. More eggs, too. But you definitely need to drink less sugary soda. And, as always, don't forget your vegetables. Recommendations Thursday from a government advisory committee call for an environmentally friendly diet lower in red and processed meats. But the panel would reverse previous guidance on limiting dietary cholesterol. And it says the caffeine in a few cups of coffee could actually be good for you. (Jalonick, 2/19)

One company, 23andMe, had discontinued the test in late 2013 after the Food and Drug Administration warned it must be approved before marketing. Elsewhere, scrutiny pinches drug compounding companies and a sunscreen law awaits federal review.

The New York Times:
FDA Eases Access To DNA Tests Of Rare Disorders
The genetic testing company 23andMe on Thursday took a step toward being able to offer consumers health-related information again, winning approval from the Food and Drug Administration for a test for mutations that cause a rare disease. The company, a pioneer in offering genetic tests direct to consumers from a sample of spit, stopped doing health-related testing in late 2013 after the F.D.A., in a scathing warning letter, said that such tests required the agency’s approval before they could be marketed. (Pollack, 2/19)

The Associated Press:
FDA Eases Access To DNA Screening For Inherited Diseases
Federal health officials are easing access to DNA tests used to screen parents for devastating genetic disorders that can be passed on to their children. The surprise announcement offers a path forward for Google-backed genetic testing firm 23andMe, which previously clashed with regulators over its direct-to-consumer technology. (Perrone, 2/19)

The Wall Street Journal's Pharmalot:
Compounding Pharmacies Feel A Squeeze
As far as compounding pharmacies are concerned, the U.S. Food and Drug Administration is compounding their problems. Compounders make drugs prescribed by doctors for specific patients whose needs aren't met by commercially available drugs. But since a meningitis outbreak that claimed 64 lives two years ago was traced to a compounding pharmacy, the agency has cracked down. Dozens of compounders have been inspected, and some were issued warning letters for poor practices. In a few instances, the FDA urged the public to avoid a compounder’s medicines or attempted to shutter an operation. (Silverman, 2/19)

CQ Healthbeat:
FDA Throws Roadblocks In Front Of Sunscreen Law
A new law to speed federal review of sunscreens is causing problems for the Food and Drug Administration, which is insisting on additional tests that could undercut the measure's targets. Skin cancer patient advocates had hoped safer suntan lotions would be available as early as this summer under the law, which allows the FDA to respond to a backlog of over-the-counter sunscreen ingredient applications – some of which have languished at the agency for decades – in an expedited manner. (Zanona, 2/19)

The research suggests that correcting the imbalance could be key to addressing Latino health disparities. In another publication, The New England Journal of Medicine, two opinion pieces look at bias among physicians and its effect on black patients.

Los Angeles Times:
Number Of Latino Doctors Isn't Keeping Pace With Population, Study Says
Latinos as a group suffer disproportionately from poverty-related conditions such as diabetes and heart disease. Under the Affordable Care Act, more of them than ever have access to coverage. But in a recent analysis published by the journal Academic Medicine, [Dr. Gloria] Sanchez and colleagues found that the number of Latino physicians was not keeping pace with population growth and suggested that correcting the imbalance could be key to addressing Latino health disparities. (Brown, 2/19)

USA Today:
Medical Leaders Cite Discrimination, Calls For Advocacy
Leaders in the medical community have published a pair of perspective pieces in the New England Journal of Medicine saying implicit bias among physicians is adversely affecting the health of black patients, and calling on the medical community to advocate against this. In one piece, Mary Bassett, New York City health commissioner, suggests health professionals should be accountable for battling the racism that contributes to poor health. The medical community must first acknowledge injustices in medical experimentation on black patients, Bassett writes. She also cites a lack of diversity among doctors. Only 4% are black, compared to 13% of the population, she says. (Eversley, 2/19)

The letter comes as officials are nearing an announcement on rates for the program. Meanwhile, Humana announces that the Justice Department is looking into allegations that it overcharged the government in its Medicare programs.

Politico Pro:
Don’t Cut MA Rates, Senators Urge Administration
More than half of the Senate is asking the Obama administration not to cut the Medicare Advantage program next year. ... The letter marks one of the first salvos in the annual lobbying push over Medicare Advantage rates. CMS is expected to release its proposed 2016 rates on Friday, and final rates will be posted on April 6. The MA rate-setting cycle has followed a similar pattern for several years: The agency would propose cuts, the industry and members of Congress from both parties would push back on them, and then CMS would backpedal on at least some of the reductions. (Haberkorn, 2/19)

The Center for Public Integrity:
Humana Facing New Federal Scrutiny Over Private Medicare Plans
Giant health insurer Humana, Inc. faces new scrutiny from the Justice Department over allegations it has overcharged the government by claiming some elderly patients enrolled in its popular Medicare plans are sicker than they actually are. The Louisville, Kentucky-based company disclosed the Justice Department’s recent civil “information request” in an annual report filed with the Securities and Exchange Commission on Feb. 18. The company noted that it is cooperating with authorities. (Schulte, 2/19)

Also in the news is a new report about long-term care insurance.

The New York Times:
Long-Term Care Insurance: Costs Are Up But Vary Widely
Rates for long-term care insurance, which can help pay for care in your own house or in a nursing home, rose this year an average of nearly 9 percent, a new industry report finds. Still, rates vary greatly depending on the insurer and the specifics; increases for some policies were much larger, and in some cases — like certain policies covering couples — quite modest, according to Jesse Slome, executive director of the American Association for Long-Term Care Insurance, a trade group. (Carrns, 2/20)

The Associated Press:
Senate OKs Ban On Insurance Policies That Cover Abortion
Women in Arizona won't be able to buy health insurance policies on the federal marketplace exchange that include abortion coverage under a bill approved by the Senate on Thursday. Senate Bill 1318 passed on a 17-12 vote, with all Senate Republicans who voted supporting the bill. Democratic Sen. Catherine Miranda of Phoenix was the sole Democrat who voted for the bill. ... The bill now heads to the House for action.(Christie, 2/20)

Reuters:
Washington ACLU Sues State Hospital District Over Abortion Services
The American Civil Liberties Union of Washington state filed a lawsuit on Thursday against the state's third-largest public hospital district, accusing it of failing to comply with an abortion rights law. The lawsuit alleges that Skagit Regional Health, which operates a large hospital and several clinics in Skagit County about 100 miles north of Seattle, is not following the state's 1991 Reproductive Privacy Act. That law requires that any state medical facility that provides maternity care must also provide abortion care, and it prohibits the state from interfering with or denying a woman's right to an abortion. (Cavaliere, 2/19)

Scranton, Pa., Times-Tribune:
U Of S Plans To End Abortion Coverage For Cases Of Rape, Incest
To remain faithful to its Catholic identity, the University of Scranton plans to end employee health care coverage for abortions in cases of rape, incest and to preserve the life of the mother. “I recognize that abortion is a painfully divisive issue nationally and that Catholic and Jesuit colleges and universities have not been immune to this divisiveness,” university President the Rev. Kevin P. Quinn, S.J., wrote in a letter to faculty and staff last week. “Nevertheless, the moral teaching of the church on abortion is unequivocal.” (Hall, 2/20)

USA Today:
States Move To Give Terminally Ill 'Right-To-Try' Drugs
A growing number of states are considering legislation to allow terminally ill patients to gain access to experimental drugs, before the U.S. Food and Drug Administration deems them market-ready. "Right-to-try" laws were passed in five states last year — Arizona, Colorado, Louisiana, Michigan and Missouri, according to the National Conference of State Legislatures. Twenty-five more have proposed similar legislation. (Monir, 2/19)

The Milwaukee Journal-Sentinel:
Milwaukee, Madison Among Costliest For Care In U.S., Report Finds
A total hip replacement costs $9,000 to $11,000 more on average in the Milwaukee area than in Minneapolis, Boston, Cleveland or St. Louis. Placing a coronary stent in a patient costs $10,000 to $13,000 more than in Minneapolis, St. Louis, Cincinnati, Cleveland or Columbus, Ohio. And a laparoscopic appendectomy costs $7,000 to $9,000 more than in Denver, Knoxville, Tenn., or Albany, N.Y. — and twice as much as in St. Louis. For all three episodes of care, Milwaukee is among the seven most expensive metropolitan areas in the country. So, too, is Madison. (Boulton, 2/20)

The Kansas Health Institute News Service:
Mental Health Drug Bill Passes Kansas Senate Committee
The Senate Public Health and Welfare Committee on Wednesday passed a bill that would allow KanCare, the state’s privatized Medicaid program, to regulate mental health patients’ access to antipsychotic medications. Although the measure, Senate Bill 123, passed on a 6-3 vote, two of its backers — Republican Sens. Mitch Holmes of St. John and Jim Denning of Overland Park — said their support was “cautious” due to the committee’s uncertainty about how the Kansas Department of Health and Environment intended to regulate the prescription processes. (Ranney, 2/19)

The Des Moines Register:
Iowa House Takes Another Look At Telemedicine
A House subcommittee advanced a bill Thursday that would help regulate the state’s telemedicine industry. Physicians increasingly are using videoconferencing and other technology to speak with patients who are not physically present in their offices. It’s a practice particularly useful for rural areas of the state that don’t have high concentrations of specialized practitioners. (Pfannenstiel, 2/19)

Los Angeles Times:
Harris Discusses Looming Decision On Sale Of Catholic Hospitals
California Atty. Gen. Kamala D. Harris said she is nearing a decision on the hotly debated proposed sale of a chain of struggling Catholic hospitals to a for-profit company in Ontario. “We’re going to be looking at it and making a decision based on protecting access to healthcare services and maintaining the continuity of care -- that's a big concern and a big issue -- and then protecting workers," Harris said. ... Harris is facing a Friday deadline to decide whether to sign off on Prime Healthcare Services Inc.'s proposed purchase of six California hospitals operated by the Daughters of Charity Health System. (Pfeifer and Mehta, 2/19)

Each week, KHN compiles a selection of recently released health policy studies and briefs.

JAMA Internal Medicine:
Patient-Centered Medical Home Implementation And Use Of Preventive Services
The patient-centered medical home (PCMH) model of primary care is being implemented in a wide variety of socioeconomic contexts, yet there has been little research on whether its effects differ by context. Clinical preventive service use, including cancer screening, is an important outcome to assess the effectiveness of the PCMH .... A longitudinal study spanning July 1, 2009, through June 30, 2012, using data from the Blue Cross Blue Shield of Michigan Physician Group Incentive Program was conducted. ... The implementation of a PCMH was associated with higher breast, cervical, and colorectal cancer screening rates .... PCMH implementation was associated with larger increases in screening in lower socioeconomic practice settings. (Markovitz et al., 2/17)

JAMA Ophthalmology:
Outcomes Of An Inner-City Vision Outreach Program
[Researchers sought to] characterize the demographic characteristics and ophthalmic conditions in children attending Give Kids Sight Day (GKSD), an outreach ophthalmic care program held annually in Philadelphia .... We studied 924 children ... coming from 584 families who attended GKSD 2012, of whom 27% were uninsured and 10% were not aware of their insurance status. Forty-two percent ... had public insurance, which covered vision care and glasses, but 35% did not know their benefits and did not realize vision care was covered. Forty-nine percent of children attended because they failed community vision screening. Provision of free glasses and failure of previous vision screening were the most common reasons families elected to attend GKSD. (Dotan et al., 2/13)

The Kaiser Family Foundation:
The ACA And Medicaid Expansion Waivers
As of February 2015, 29 states including DC are implementing the [Medicaid] expansion. Nearly all states (24 of 29) are implementing the expansion as set forth by law, but a limited number of states have obtained or are seeking approval through Section 1115 waivers to implement the expansion in ways that extend beyond the flexibility provided by the law .... This brief provides an overview of the role of Section 1115 waivers in expanding coverage since the enactment of the ACA. The brief also highlights key themes in these waivers including implementing the Medicaid expansion through a premium assistance model, charging premiums, eliminating certain required benefits (most notably non-emergency medical transportation), and using healthy behavior incentives. (Rudowitz, Artiga and Musumeci, 2/17)

The Kaiser Family Foundation:
Are Uninsured Adults Who Could Gain Medicaid Coverage Working?
As additional states consider whether to implement the [Medicaid] expansion, some have raised pursuing waiver authority to tie Medicaid eligibility for adults under the expansion to work requirements. This fact sheet profiles uninsured adults who could gain Medicaid coverage under the ACA by their relationship to the workforce and job-based coverage. ... Nearly three out of four (72%) of the uninsured adults who could gain Medicaid coverage live in a family with at least one full-time or a part time worker and more than half (57%) are working full or parttime themselves. ... Most uninsured adults who would be eligible for the
Medicaid expansion work in firms and industries that often have limited employer-based coverage options. (2/13)

The Urban Institute:
Certificates Of Public Advantage Can They Address Provider Market Power?
A key problem [in health spending] is provider pricing power in increasingly concentrated health delivery markets. The growth of pricing power follows recent waves of hospital mergers, the emergence of “must-have” hospitals, and increasing integration with physicians. Antitrust law alone has done little to maintain competitive pricing. One alternative is the use of Certificates of Public Advantage (COPAs) to oversee merged hospitals. COPAs are seldom used, but one has operated in Western North Carolina for nearly 20 years. ... We conclude that this application of the COPA model has some successes, and with modifications a COPA-like approach could provide a useful complement to antitrust enforcement in addressing market power. (Bovbjerg and Berenson, 2/18)

Here is a selection of news coverage of other recent research:

Reuters:
Racial Gaps In Diabetes Not Tied To Social, Economic Status
Social and economic status does not explain the racial gaps in the care and outcomes of kids with type 1 diabetes, according to a new study. The finding suggests researchers look to other factors that may explain the racial gap in type 1 diabetes care, such as the perceptions of doctors and families, write the researchers in the journal Pediatrics February 16. (Doyle, 2/16)

Reuters:
U.S. Cancer Survival Rates Improving
The proportion of people surviving years after a cancer diagnosis is improving, according to a new analysis. Men and women ages 50 to 64, who were diagnosed in 2005 to 2009 with a variety of cancer types, were 39 to 68 percent more likely to be alive five years later, compared to people of the same age diagnosed in 1990 to 1994, researchers found. Seaman, 2/19)

Reuters:
Disabled Elderly Decline Sharply After ICU
Seniors admitted to the hospital intensive care unit (ICU) were more likely to die or sharply decline soon after their release depending on how well they functioned beforehand, according to a new study. ... Those who had mild to moderate disability before ICU admission were twice as likely as the minimally disabled to die within one year of ICU admission, and those with severe disability were three times as likely to die. Those who started out minimally disabled had much better outcomes, and should be targeted for aggressive rehabilitation since they have a good chance of recovering all of their pre-ICU function, Ferrante said. (Doyle, 2/12)

The New York Times:
The Plot To Kill Health Care
Republicans hate activist judges — those black-robed elites who are willing to upset the lives of millions of people just to further a political cause. Ditto trial lawyers trolling for clients, the ambulance-chasing, “Better Call Saul” guys. They hate them, until they need them. And in the raw power play that is behind the attempt to kick millions of people off health care gained through the Affordable Care Act, Republicans are attempting one of the most brazen manipulations of the legal system in modern times. To pull it off, they’re relying on a toxically politicized judiciary to make law, and to make a mockery of everything that conservative legal scholars profess to believe. (Timothy Egan, 2/20)

Forbes:
Contra White House, Obamacare Exchanges Enroll Roughly 5 Million Uninsured, Not 11.4 Million
Last night, the White House tweeted that “about 11.4 million Americans are signed up for private health coverage” through Obamacare’s insurance exchanges. President Obama claims that this figure proves that his health law is working. But once you unravel the spin, what the latest numbers show is that the pace of enrollment in Obamacare’s exchanges has slowed down by more than half. If previous trends hold, Obamacare exchanges have enrolled roughly 5 million previously uninsured individuals: a far cry from 11.4 million. (Avik Roy, 2/18)

The Wall Street Journal:
The ACA Enrollment Story Is In The States
The Obama administration announced this week that 8.6 million people had signed up for coverage in the 37 states using HealthCare.gov and estimated that an additional 2.8 million had signed up in states operating their own exchanges during the Affordable Care Act open-enrollment season that closed Sunday. ... Beneath these numbers lies significant variation in the enrollment experiences in the states using HealthCare.gov. The aggregate national enrollment figures get a lot of attention in Washington and in the media amid the ongoing debate about the health-care law–but the state numbers can be more revealing. (Drew Altman, 2/19)

The New York Times:
Cranking Up For 2016
Across the board, the modern American right seems to have abandoned the idea that there is an objective reality out there, even if it’s not what your prejudices say should be happening. What are you going to believe, right-wing doctrine or your own lying eyes? These days, the doctrine wins. Look at another issue, health reform. Before the Affordable Care Act went into effect, conservatives predicted disaster: health costs would soar, the deficit would explode, more people would lose insurance than gain it. They were wrong on all counts. But, in their rhetoric ... they simply ignore this reality. (Paul Krugman, 2/20)

USA Today:
Affordable Care Act Is Working
Over the past three months, millions of Americans sent a powerful message: The Affordable Care Act is working, and the quality health coverage offered on its Health Insurance Marketplace is a product that consumers need, want and like. ... Health insurers sent a message as well. Twenty-five percent more of them offered coverage in the Marketplace compared to the last open enrollment. ... Given this progress, it's time to move beyond efforts to repeal the Affordable Care Act. (Health and Human Services Secretary Sylvia M. Burwell, 2/19)

The Wall Street Journal:
Three Ways To Create Smarter Health-Care Consumers
Even Americans with health insurance are paying more out of pocket for their care as medical costs increase and insurance coverage gets leaner, with higher deductibles and copays. This means that more people are making tough choices about whether to forgo recommended treatments. The key to making those choices is good information on both the benefits and costs of care. (David Blumenthal, 2/19)

The Washington Post:
A Historic, Bipartisan Medicaid Proposal For Virginia
[Virginia Gov. Terry] McAuliffe tried for months to get about 400,000 people added to Medicaid. The General Assembly said no. Now he is aiming to add about 20,000. But, adopting the right mix of incentives — and enforcement — to spur those already covered to use Medicaid would produce a far greater expansion in usage, the supposed goal, than the General Assembly will pass this year. (Norman Leahy and Paul Goldman, 2/19)

The Wall Street Journal:
How Much Of Your Taxes Go To Health Care? Do The Math.
Between state, federal and Medicare taxes, and insurance premium growth potentially displacing wage increases, you paid a high price for health care in 2014—even if you were healthy and never used the system once. Health care is very important to all of us, which is why we are willing to pay so dearly for it. But at this high a cost, we ought to expect better than the rampant waste, errors and quality problems that plague the system. No voter with a W-2 should elect a politician who won’t fight for the best care at the best price. (Leah Binder, 2/19)

The New England Journal of Medicine:
#BlackLivesMatter — A Challenge To The Medical And Public Health Communities
Ongoing exclusion of and discrimination against people of African descent throughout their life course, along with the legacy of bad past policies, continue to shape patterns of disease distribution and mortality. There is great injustice in the daily violence experienced by young black men. But the tragedy of lives cut short is not accounted for entirely, or even mostly, by violence. ... Physicians, nurses, and public health professionals witness such inequities daily: certain groups consistently have much higher rates of premature, preventable death and poorer health throughout their lives. Yet even as research on health disparities has helped to document persistent gaps in morbidity and mortality between racial and ethnic groups, there is often a reluctance to address the role of racism in driving these gaps. (Dr. Mary T. Bassett, 2/18)

The New England Journal of Medicine:
Bias, Black Lives, And Academic Medicine
What are the systemic biases within academic medical centers, and what do they have to do with black lives? Two observations about health care disparities may be relevant. First, there is evidence that doctors hold stereotypes based on patients' race that can influence their clinical decisions. ... Second, despite physicians' and medical centers' best intentions of being equitable, black–white disparities persist in patient outcomes, medical education, and faculty recruitment. (Drs. David A. Ansell and Edwin K. McDonald, 2/18)

news@JAMA:
Is The Patient CARE Act Heir Apparent To The Affordable Care Act?
The first week of February was an eventful one on Capitol Hill. First, on February 3, 2015, the House of Representatives passed HR 596, its 56th attempt to repeal the Affordable Care Act (ACA). Two days later, a news release from the Senate Committee on Finance announced that Republican Senators Richard Burr (NC), Orrin Hatch (Utah), and Fred Upton (Mich) unveiled the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act, described as a “legislative plan that repeals Obamacare and replaces it with common-sense, patient-focused reforms that reduce health care costs and increase access to affordable, high-quality care.” (Adashi, 2/18)

The New England Journal of Medicine:
Healthcare.Gov 3.0 — Behavioral Economics And Insurance Exchanges
[I]t will soon be time to tackle the much more challenging job of designing exchange websites in ways that maximize the chances that consumers will choose plans best suited to their needs and preferences. If the first round of open enrollment was primarily about avoiding catastrophe and the second round was about ironing out wrinkles in the underlying programming code, then version 3.0, in our view, should focus on redesigning the way exchanges present their insurance choices, to avoid features known to bias people's decisions. (Peter A. Ubel, David A. Comerford and Eric Johnson, 2/18)